Enroll

Registration for 2011-2012 is open

We are accepting registrations for kindergarten,(KG1-KG2 for now, please contact our office for your day care registrations.


 SEE FORM BELOW:
 PLEASE PRINT CLEARLY AND FILL THE FORM, INCLUDE A 3X4  PHOTO OF BOTH PARENTS OR GUARDIAN INCLUDING THE CHILD'S PHOTO YOU WISH TO ENROLL.

KINDERGARTEN REGISTRATION FOR THE 2011-2012 SCHOOL YEAR IS OPEN

SAVE TIME BY REGISTERING ON-ONLINE Go to ( Schedule Appointment)  by the right of this page and send a quick inquiry we will respond as soon as possible , Note Adult Education Registration fee is $50. Contact us or visit enroll- page for school  fees information. 


 (PRINT FORM -FILL AND SEND WITH A 3X4 COLORED  PHOTO OF FATHER , MOTHER OF THE CHILD OR GUARDIAN  AND THE PHOTO OF THE CHILD YOU WISH TO ENROLL TO OUR SCHOOL) 
If you have any questions relating to registration or to the curriculum, please call:
 School director ( 855 2365-23300)
    
  Form No.bsecam011 

BIG SUCCESS EDUCATION CENTER

STUDENT DATA INFORMATION FORM

1. Name _____________________ Surname________________________

Middle Generation Suffix (Jr, etc) __________________________________

2.Street:_____________________________________________________

Address_____________________________________________________


___________________________________________________________

3.City: __________________ Province_______________ Zip Code_________

Mailing Address:______________________________________________

__________________________________________________________

(If different than home address )

4. Home Telephone Number: _______________________________

Mother Cell Phone Number: ________________________________

Father Cell Phone Number: _________________________________

5. Date of Birth: _________________________________________

6.Country of Birth: _______________________________________

7.Place of Birth: _________________________________________


 (City, State)____________________________________________

8.. Evidence:


 Birth Certificate __________________________________________ 

Proof of Residence:_______________________________________

(Utility Bill, Deed, Lease, etc.)__________________________________

9. Gender: _________________

Female ___________________

Male_____________________

10. Primary Language spoken in the home:___________________________

Child's Primary Language: __________________________________________________

Child's Secondary Language: _________________________________________________

11. Ethnicity:  (Asia/European/African etc..) _________________________________

Race:

 Indicate if Mixed ________________________________

American White______________________________________

African Black________________________________________

African American _____________________________________

Asian____________________________________________________

12. Student Lives with:


Mother Only ___________________________________________

Father Only ____________________________________________

Both Parents ____________________________________________

Guardian_______________________________________________

13. Father/Guardian_______________________________________

Employer Name: __________________________________________

First Name___________________ Last Name___________________

Work Address: ___________________________________________

_______________________________________________________

Work Telephone No. ________________________________________

(City, State)______________________________________________

Mother/Guardian__________________________________________

Employer Name: __________________________________________

First Name_______________________ Last Name_______________

Work Address: _______________________________________

__________________________________________________

Work Telephone No. ___________________________________

(City, State)_________________________________________

14. Local persons to be called if your child is ill and you are unavailable:
 (Parents are called first)

Name Telephone Relationship to Child

A._____________________________________________________

______________________________________________________

B. ____________________________________________________

______________________

C. _____________________________________________________

______________________

15. Please provide below type of formal pre-school experience your child has had? How many months?

________________________________________________________

________________________________

________________________________________________________

________________________________

Name of School______________________________________________

Date ________/_______/_________

 Parent's Signature _____________________________________

For official use only.

School Use Only: Local Student ID Number: _________________________ Registration Number: _____________________________  School: _______________________________________ Level _________________________________________ Teacher _________________Signature_______________  Year_____________________ Date_____/____/______ Principal________________Signature_________________

                                                               

Note: Student Records may be reviewed by parents or guardians by making an appointment with the Principal or the Director of Pupil Personnel Services. 

IMPORTANT NOTICE!

MEETING FOR ALL PARENTS:

    To explain our Kindergarten program and other program options, to parents/guardians of all potential Kindergartners/daycare, we will have a presentation by members of our administrative staff as soon as we have completed the first registration process. This meeting will be held at the school premises.

 Your children should not attend the meeting.

FOR EVENING REGISTRATION - 
By appointment only (call 0236-523-300 to schedule) on Monday - Friday 4:30pm from 6:00pm. 

REGISTRATION FOR FIRST GRADERS NOT CURRENTLY ENROLLED

Bsec is not currently accepting First Graders registration, Information will be posted online as soon as we begin taking in new students.   Telephone numbers are listed below.  To determine which school your child will attend, contact us by phone for the listing of grades with the program assigned.

Contact: 

No 92D Street 350 BKK III Commune

 Chomkarmon District, Phnom Penh Cambodia

Tel: 855-2365-23300

 Mob:English/ 855-887-927-443
Registration is time consuming so do not bring your children.